Modified Dental Anxiety Scale Scores Research Articles

Impact of non-surgical periodontal treatment on dental anxiety: A comparative study on patients with periodontitis

Background/purposeDental anxiety is prevalent and may result in the avoidance of periodontal therapy and maintenance. This study aimed to explore the impact of non-surgical periodontal treatment (NSPT) on dental anxiety among patients with periodontitis. Materials and methodsIn this study, 122 patients with periodontitis participated. The Chinese version of the Modified Dental Anxiety Scale (MDAS) gauged baseline dental anxiety during the initial appointment. Patients receiving non-surgical periodontal treatment (NSPT) in subsequent appointments formed the NSPT group, while those with a delayed NSPT of at least two months constituted the delayed group. In the NSPT group, the second termination questionnaire was administered one month post the last NSPT visit, just before the periodontal re-evaluation. In the delayed group, the second questionnaire was completed before the delayed NSPT initiation. ResultsBaseline MDAS scores were comparable between the delay and NSPT groups. However, the NSPT group exhibited lower total scores and scores for each of the five MDAS items at termination compared with the delay group. At baseline, MDAS total scores were inversely associated with age and were lower in males. A reduction in MDAS total scores between observation points was correlated with NSPT, sex, and age after adjustment. Regarding MDAS item 4 (teeth scaled/polished), score reduction consistently correlated with NSPT and age. ConclusionParticipation in NSPT may alleviate dental anxiety, and consequently enhance the patients' conceptiveness to undergo periodontal maintenance or surgery.

Analysis of acupoint massage combined with touch on relieving anxiety and pain in patients with oral implant surgery.

Oral implant surgery is an effective procedure for artificial implants in missing tooth areas under local anesthesia. Because patients under local anesthesia are conscious during this procedure, compared with general anesthesia-related operations, they are more likely to experience negative emotions, such as anxiety and tension. These emotional reactions result in shivering and chills in the limbs, leading to poor doctor-patient cooperation and even avoidance of treatment. In traditional Chinese medicine, it is believed that acupoint massage regulates blood and Qi, dredge menstruation, and relieve pain, which is beneficial for patients' emotional adjustment; however, there are few related clinical studies. To observe the changes in anxiety and pain in patients with oral implant after acupoint massage combined with touch therapy. One hundred patients undergoing oral implantation in our hospital between May 2020 and May 2023 were randomly divided into control and study groups, according to a random number table, with 50 patients in each group. The control group received routine intervention, and the study group received acupoint massage combined with touch on the basis of the control group. Anxiety [assessed using the Modified Dental Anxiety Scale (MDAS)], pain severity, blood pressure, heart rate, and satisfaction were compared between the two groups. Before intervention, the difference in MDAS score between the two groups was not significant (P > 0.05), while after the intervention, the MDAS scores decreased in both groups compared with those before the intervention (P < 0.05); the MDAS score of the study group was lower than that of the control group, with a statistically significant difference (P < 0.05). The degree of pain in the intervention group was significantly lower than that in the control group (P < 0.05). Before the intervention, there were no significant differences in systolic and diastolic blood pressures or heart rate between the two groups (P > 0.05). The systolic and diastolic blood pressures and heart rate in the intervention group, during and after the intervention, were significantly lower than those in the control group (P < 0.05). The total degree of satisfaction in the study group was significantly higher than that in the control group (P < 0.05). Acupoint massage combined with touch better relieves anxiety and pain in patients undergoing dental implant surgery, improving the perioperative comfort of these patients and ensuring safety and a smooth operation.

Influence of experiencing SARS-CoV-2 infection on anxiety levels in Chinese patients undergoing third molar surgery.

In China, most of the citizens experienced SARS-CoV-2 infection since the end of 2022. The Coronavirus disease 2019 (COVID-19) pandemic affected people's physical health and also had a significant impact on mental well-being. The present study aims to discover if the experience of SARS-CoV-2 infection influences patients' anxiety toward third molar surgery in the Chinese population. The present study took the form of a questionnaire survey. From January 1, 2023, to June 30, 2023, patients who went to the Stomatology Center of China-Japan Friendship Hospital (Beijing, China) for the third molar extraction were included according to the inclusion criteria. The information on COVID-19 infection and the Modified Dental Anxiety Scale (MDAS) was collected. The software SPSS 22.0 was used for the statistical analyses. A total of 574 survey results were harvested in the present study. The infection rate of COVID-19 was 86.6% (p > 0.05). The Average MDAS scores between patients who had been infected with COVID-19 and patients who were never infected were not significantly different (11.65 ± 4.41 vs. 11.42 ± 4.41, p > 0.05). The subgroup analysis was conducted according to the length of time after the recovery of COVID-19 (Model 1), and the highest temperature during the infection (Model 2). In Model 1 and Model 2, the one-way ANOVA test did not find statistical significance between the groups (Model 1 p = 0.114; Model 2 p = 0.481). The MDAS scores in female patients were significantly higher than in male patients (12.29 ± 4.53 vs. 9.91 ± 3.80, p < 0.001). Patients who extracted double teeth got significantly higher MDAS scores than those who extracted single teeth before the surgery (12.03 ± 4.74 vs. 11.24 ± 4.18, p = 0.037). The present study did not establish a significant impact of SARS-CoV-2 infection on the anxiety levels associated with third molar surgery among Chinese patients. The potential long-term biopsychological effects of the virus warrant further investigation.

Predicting dental anxiety in young adults: classical statistical modelling approach versus machine learning approach

ObjectivesTo predict and identify the key demographic and clinical exposure factors associated with dental anxiety among young adults, and to compare if the traditional statistical modelling approach provides similar results to the machine learning (ML) approach in predicting factors for dental anxiety.MethodsA cross-sectional study of Western Illinois University students. Three survey instruments (sociodemographic questionnaire, modified dental anxiety scale (MDAS), and dental concerns assessment tool (DCA)) were distributed via email to the students using survey monkey. The dependent variable was the mean MDAS scores, while the independent variables were the sociodemographic and dental concern assessment variables. Multivariable analysis was done by comparing the classical statistical model and the machine learning model. The classical statistical modelling technique was conducted using the multiple linear regression analysis and the final model was selected based on Akaike information Criteria (AIC) using the backward stepwise technique while the machine learining modelling was performed by comparing two ML models: LASSO regression and extreme gradient boosting machine (XGBOOST) under 5-fold cross-validation using the resampling technique. All statistical analyses were performed using R version 4.1.3.ResultsThe mean MDAS was 13.73 ± 5.51. After careful consideration of all possible fitted models and their interaction terms the classical statistical approach yielded a parsimonious model with 13 predictor variables with Akaike Information Criteria (AIC) of 2376.4. For the ML approach, the Lasso regression model was the best-performing model with a mean RMSE of 0.617, R2 of 0.615, and MAE of 0.483. Comparing the variable selection of ML versus the classical statistical model, both model types identified 12 similar variables (out of 13) as the most important predictors of dental anxiety in this study population.ConclusionThere is a high burden of dental anxiety within this study population. This study contributes to reducing the knowledge gap about the impact of clinical exposure variables on dental anxiety and the role of machine learningin the prediction of dental anxiety. The predictor variables identified can be used to inform public health interventions that are geared towards eliminating the individual clinical exposure triggers of dental anxiety are recommended.

The disparities of dental anxiety in adult dental patients: a sociodemographic and dental visit experience analysis

ABSTRACTIntroduction: Patient anxiety can impede dental treatment adherence. Several factors influence patient anxiety, including sociodemographic characteristics and prior dental visit experiences. This study aims to analyze the disparities of dental anxiety in adult dental patients from sociodemographic and dental visit experience analysis point of view. Methods: Type of research was cross-sectional study. The population was all dental patients during May 30th and June 16th, 2023 at the Cipondoh Public Health Center in Tangerang City. Sixty-one patients were purposely sampled from the dental clinic. Data were collected via a self-administered questionnaire containing five questions regarding sociodemographic factors and dental visit experiences. Each question offered respondents five response options, represented by scores. Anxiety was measured using the Modified Dental Anxiety Scale (MDAS), and statistical analysis was performed using SPSS version 26 with Mann-Whitney, ANOVA, Kruskal Wallis tests. Results: Among the 61 participants, 33.1% reported experiencing dental anxiety, with an average MDAS score of 8.92. Comparative analysis revealed significant differences in anxiety scores based on age (p&lt;0.05), gender (p&lt;0.05), education level (p&lt;0.05), and dental visit experience (p&lt;0.05). Conclusion: There are significant anxiety differences in adult patients based on sociodemographic factors, including gender, age, educational level, and dental experience factors. Keyword : dental anxiety, socioeconomic factors, dental visit, adult

The effect of parental presence on the anxiety during first dental treatment in children

Objective The aim of this study was to evaluate the effect of parental presence on dental anxiety in children during dental treatments. Materials and methods The study was conducted with 194 children between January-April, 2020. The children were randomly divided into two subgroups. Children in group-I were treated in parent’s presence (pp), and in group-II in parent’s absence (pa). The Wong-Baker FACES Pain Rating Scale (WBFPS) and The Modified Dental Anxiety Scale (MDAS) were used for subjective measurements, whereas the objective measurement was performed by measuring the heart rate. Results The mean age of 194 children was 6.26 ± 1.15 years, ranging from 5-8 years of age. The mean MDAS score of all children was 15.1 ± 4.72. No significant correlations were found in terms of dental anxiety between the children’s gender and age with heart rate, WBFPS and MDAS scores. Preoperative WBFPS scores (6.83 ± 1.04 pp and 7.01 ± 0.93 pa) were higher than postoperative scores (5.34 ± 2.11 pp and 5.74 ± 2.04 pa), with no statistically significant difference. Although there was no statistically significant results, the paediatric dentist observed a deterioration in the children’s behavior throughout the sessions in group-II compared to children in group-I. Conclusions Parental presence has no statistically significant effect on dental anxiety in children during dental treatments.

Evaluation of Dental Anxiety Levels of the Oral and Dental Health Program Students

Objective: This study aimed to compare the dental anxiety levels of 1st and 2nd year oral and dental health program students.&#x0D; &#x0D; Method: A total of 91 students, 47 1st year and 44 2nd year students, studying in the oral and dental health programs were included in our study. The modified dental anxiety scale (MDAS), which consists of five questions frequently preferred for assessing dental anxiety and questionnaires containing demographic information, were distributed to the participants. The participants with an MDAS score of 19 and/or above were considered to have a high level of dental anxiety. Statistical analysis of the data obtained was performed using Student’s t-test and one-way analysis of variance.&#x0D; &#x0D; Results: In all questions, the 1st year students had higher MDAS scores, and in the third and fourth questions, a significant difference was found between the groups in terms of scores (p &lt; 0.05). The mean MDAS score obtained from the 1st year students (12.72 ± 4.72), was found to be significantly higher than the mean MDAS score obtained from the 2nd year students (10.29 ± 4.22) (p &lt; 0.05). &#x0D; &#x0D; Conclusion: As oral and dental health programs students’ level of knowledge about dental treatments increases, their dental anxiety decreases. In line with these data, dental anxiety levels can be reduced by increasing the level of education and dental knowledge of individuals.

Prevalence and factors associated with dental anxiety among pregnant women seeking care at a tertiary care dental institution in Sri Lanka

To determine the prevalence and factors associated with dental anxiety among pregnant women seeking care at the Preventive Oral Health Unit, Institute of Oral Health, Maharagama, Sri Lanka. The participants of this descriptive cross-sectional study were 402 pregnant women seeking care at the Institute of Oral Health, Maharagama for the first time. A validated Sri Lankan version of the Modified Dental Anxiety Scale (MDAS) was used to measure dental anxiety and an interviewer-administered questionnaire collected information about demographics, dental service utilization, knowledge, and the importance of oral health during pregnancy. The prevalence of dental anxiety was 61.7% and the mean MDAS score in the dentally anxious and not anxious were 13.4±3.8 and 9.20 ± 1.7 respectively. According to the binary multiple logistic regression model current employment status, household income, dental care seeking pattern, having had a negative experience during a previous visit to a dentist,poor awareness about the importance of oral health in pregnancy, not receiving oral health instructions from health care providers during pregnancy, the perception that oral care should be avoided during pregnancy were independently associated with dental anxiety. The prevalence of dental anxiety was high among this sample of pregnant women.

THE EFFECT OF THE EDUCATION LEVELS OF DENTAL STUDENTS ON THEIR DENTAL ANXIETY

The purpose of this study was to compare dental anxiety levels among first-, second-, third-, fourth- and fifth-year dental students. To evaluate the level of dental anxiety against dental interventions, online questionnaires were applied to first year (n=96), second year (n=96), third year (n=109), fourth year (n=107) and fifth year (n=92) dental students. The students' demographic information (age, gender) was also recorded. These questionnaires included the Modified Dental Anxiety Scale (MDAS). The students whose MDAS score was ≥19 were considered as highly anxious. The statistical analysis was performed using IBM SPSS Statistics 24 (IBM SPSS, USA). This study was conducted with a total of 500 students including 220 male and 280 female students. The students with an MDAS score of 19 (having dental anxiety) were 23 people (4.6%) in total. No statistically significant difference was found between the class years of the students in terms of their mean MDAS scores (p: 0.387). When the responses given to the 5 items in MDAS were evaluated, only the responses given to the 1st and 5th questions had statistically significant differences (p

Dental pain perception and emotional changes: on the relationship between dental anxiety and olfaction

BackgroundThe purpose of the study was to determine to what extent olfactory aromatherapy reduces the intensity of dental pain and the level of dental anxiety. It also attempted to corelate between olfactory aromatherapy, stages of dental visits, and various dental procedures.MethodsFemale patients were enrolled in a randomized controlled study. Olfactory aromatherapy was performed using lavender oils. Patients were randomly assigned to one of two groups: the lavender group, in which patients inhaled 2% lavender vapors, and the control group, in which patients inhaled water vapors. Pain score, anxiety score, and changes in vital signs were among the predictable variables. Anxiety and pain were assessed using the Modified Dental Anxiety Scale (MDAS), Speilberger State-Trait Anxiety Inventory (STAI), and visual analog scales (VAS). The vital signs were systolic (SBP) and diastolic (DBP), heart rate (HR), respiratory rate (RR), and oxygen saturation (Spo2). Variables were evaluated before inhalations, 20 min after inhalations, at the end of settings, and on the following day.ResultsEach group had 175 participants. Pain and anxiety scores were significantly reduced, and all vital signs improved, except for DBP. The MDAS, STAI, and pain scores are reduced by 3.4, 4.2, and 2.4 times, respectively, compared to the control group. Olfactory aromatherapy had the greatest impact during the phase of waiting rooms.ConclusionWhen compared to the control group, olfactory aromatherapy reduces anxiety scores three to four times more. Pain perception is reduced by twice as much as in the control group. It also significantly reduces the anxiety associated with minor to moderately stressful dental procedures.

Investigation of the effect of music listened to by patients with moderate dental anxiety during restoration of posterior occlusal dental caries.

The aim of this randomized controlled study was to investigate the effect of music therapy during restorative dental treatments on patients with moderate dental anxiety. Seventy patients were determined to have moderate dental anxiety by the Modified Dental Anxiety Scale (MDAS) and were divided randomly into two groups (n = 35). The first group did not listen to music during their restorative treatment (control group), and the second group listened to music of their choice (experimental group). Systolic blood pressure, diastolic blood pressure, heart rate, oxygen saturation, and body temperature were measured three times for each patient: once before the treatment, once after their dental caries were removed, and once at the end of the treatment. Salivary cortisol samples were taken from each patient before and after the treatment. The MDAS was re-administered to the patients at the end of the treatment, and the data were analyzed statistically. Only the diastolic blood pressure (P = 0.042) and the MDAS scores of the experimental group (P = 0.001) were significantly lower than the control group at the end of the treatment. While music listening did not have an effect on the physiologic parameters of the patients during restorative treatment, it decreased the MDAS scores of the patients. Although music therapy did not affect the physiological parameters during the restorative dental treatment, it may help to reduce patients' self reported anxiety level.

Does Modifying the Consent Process Based on the Dominant Intelligence Type Reduce Anxiety During 3rd Molar Operations?

Third molar surgery is one of the most commonly performed operations, usually associated with high anxiety. The purpose of this study was to determine if patients' anxiety would reduce if consent was modified to match their dominant intelligence type (DIT). A single center, prospective randomized clinical study was conducted in the Maxillofacial Surgery Clinic of Ordu University on patients admitted for lower third molar removal between October 2020 and June 2021. The participants were randomly assigned to a study group where consent was based on DIT or a control group where consent was obtained in the standard fashion. DIT was determined using the multiple intelligence test and was further categorized as visual/spatial, verbal/linguistic, and bodily/kinesthetic. The consent method was the primary and the type of DIT was the secondary predictor variable. The primary and secondary outcome variables were the salivary cortisol level and Modified Dental Anxiety Scale (MDAS) scores measured before and after the consent, and after the operation. Mann-Whitney U, Friedman, Kruskal Wallis, Pearson correlation, and χ2 tests were conducted for statistical analysis. Eighty patients (55 females and 25 males; mean age 23.5±6.2) were included. No significant difference was observed between the study and control groups for the change in cortisol levels and MDAS scores before-after consent (-11.15±62.64; -6.84±32.9) (P=.389), (-0.6±3.46; -0.7±2.49) (P=.832) and before consent-after operation (-39.80±108.2; -39.72±77.04) (P=.987), (-4.31±5.97; -3±4.34) (P=.867). The change in MDAS scores and cortisol levels was not correlated after consent (P=.587, r=0.62) and operation (P=.406, r=0.94). Providing consent based on DIT is not statistically different than providing consent in the standard fashion. The role of consent strategy in managing anxiety and lack of correlation between salivary cortisol and MDAS requires further investigation.

Advantages of Sedation With Remimazolam Compared to Midazolam for the Removal of Impacted Tooth in Patients With Dental Anxiety

Although midazolam is commonly used to sedate patients with dental anxiety, it has shortcomings that reduce the satisfaction of patients and doctors. The aim of this study was therefore to explore the advantages of remimazolam as a sedative. The study design was a prospective randomized controlled trial. Patients with dental anxiety and who were to undergo impacted tooth removal were randomized into remimazolam and midazolam groups. They were sedated with remimazolam or midazolam prior to receiving nerve blocker. The predictor variable was the type of sedative, while the primary outcome variables were the onset time, awakening time, recovery time, and postoperative side effects. Secondary outcome variables were the Modified Dental Anxiety Scale score before and after surgery, patient satisfaction and comfort levels scores, and doctor satisfaction level scores. Other variables included the patient demographics and the operation time. Data were analyzed using the Student's t-test, Mann-Whitney test, χ2 test, and two-way repeated measurement ANOVA test (SPSS Version 25.0). A total of 83 patients were included in this study, with 42 randomized to the remimazolam group and 41 to the midazolam group. There were no significant differences between the two groups in terms of demographic features and operation time. Patients in the remimazolam group had significantly shorter onset time, awakening time, and recovery time compared to those in the midazolam group (each P<.001). Postoperative side effects were more frequent in the midazolam group (P<.001). Following surgery, the Modified Dental Anxiety Scale scores in both groups were significantly lower than prior to surgery (P<.001). Satisfaction levels scores for the patients and doctor were higher in the remimazolam group than in the midazolam group (P<.001). The use of remimazolam results in faster onset, more rapid recovery, and lower incidence of postoperative side effects compared to midazolam, leading to improved satisfaction for patients and doctors. Remimazolam therefore appears to have several advantages over midazolam for the sedation of patients with dental anxiety associated with the removal of impacted teeth.

Web-Based Interventions Reduced Dental Anxiety among Adults in Lithuania and Norway: A Pilot Study

Dental anxiety (DA) is a prevalent public health issue. However, there is a lack of self-administered DA interventions. The aim of this study was to evaluate the short-term effects of web-based interventions aiming to reduce DA in adults in two European countries. A pretest posttest design was used. Tailor-made websites were developed in Lithuania and Norway. Volunteers who self-reported DA were invited to participate. DA levels measured by the Modified Dental Anxiety Scale (MDAS) were assessed at baseline and after two weeks via online questionnaires. The interventions were completed by 34 participants in Lithuania and 35 participants in Norway. In Lithuania, the median posttest MDAS score (9.5, IQR 5.25) decreased compared to the median pretest MDAS score (14.5, IQR 8; Z value = -4.246, p < 0.001). The same was found in Norway-the median posttest MDAS score (12, IQR 9) was lower compared to the median pretest MDAS score (15, IQR 7; Z value = -3.818, p < 0.001). The present study demonstrated that two tailor-made web-based interventions had the potential to reduce dental anxiety levels when assessed in the short term in Lithuania and Norway. Studies with more controlled designs assessing long-term outcomes are needed to validate the results of this pilot study also in other cultures.

Relationship Between Types of Information, Dental Anxiety, and Postoperative Pain Following Third Molar Surgery: A Randomized Study

Third molar (M3) extraction is an anxiety-provoking procedure. Information mode delivery may affect patients' anxiety level and postoperative sequelae. This study determined the relationship between information types, dental anxiety, and postoperative pain following mandibular M3 extraction. Patients (aged 18 to 35years) requiring M3 extraction under local anesthesia were recruited into this prospective randomized study conducted in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. Patients were randomized to two groups; verbal or audiovisual depending on M3 extraction information received. Primary outcome variable (difference in anxiety between groups) was assessed with State-Trait Anxiety Inventory (STAI-S) and Modified Dental Anxiety Scale(MDAS). Pain recorded on postoperative days (PODs) 1, 3, and 7 using the Visual Analog Scale was the secondary outcome. Other covariables include biodata, impaction types, and difficulty indices. Data analysis was descriptive and bivariate using IBM/SPSS for Windows, version 23 (SPSS, Chicago, IL USA) with significance set at P<.05. Ninety patients referred for M3 extraction met the inclusion criteria, 45 patients in each group. The audiovisual group had significant increase in anxiety preoperatively measured by STAI-S (P=.002) and MDAS (P=.009) when compared with the verbal group. No significant differences in the STAI-S (P=.16) and MDAS (P=.216) scores were recorded at POD7. The progressive reduction in pain in both groups was not significant at POD7 (P=.746). Preoperative verbal information allayed anxiety compared to real life audiovisual information in M3 patients. These findings will provide a baseline reference data for subsequent research in our environment.

Methods Helping Dentists to Detect Dental Fear

ObjectivesDental fear is common and yet often remains unrecognised. COVID-19 has challenged health care since 2020. This study aimed to evaluate patients’ self-reported dental fear and detection of dental fear by the dentists. Another aim was to validate a colour code instrument for estimating dental fear. The influence of COVID-19 on fear and attendance was assessed. MethodsA cross-sectional survey was conducted in the primary urgent dental care of Oulu, Finland, in spring 2020 and 2021 after the first (T1) and third waves (T2) of the pandemic. Data were obtained for analyses using the Modified Dental Anxiety Scale (MDAS), Facial Image Scale (FIS), and a new “traffic light” colour code for dental fear (CCF). The influence of COVID-19 on dental fear and attendance was assessed with structured and open-ended questions. The questionnaires were completed by 273 anonymous participants. ResultsOf the participants, 167 (61.2%) visited dental care during T1 and 106 (38.8%) during T2. Their mean age was 45.1 years. An MDAS score of 19 or above, indicating severe fear, was reported by 10.6% of the participants. Of those with severe dental fear, 87% chose the red colour in the CCF “traffic light” system. The association between dentists’ and participants’ estimation of dental fear was weak (P < .001) and agreement with the red code was nonexistent (Cohen's kappa value = −0.035). MDAS scores of the younger participants were higher than those of the older ones after the first wave (T1) (P = .021). COVID-19 had the strongest influence on dental attendance and dental fear of those having the most severe self-reported dental fear as measured by the MDAS. ConclusionsColour-coded traffic lights seem valid for screening severe dental fear and are easy and quick to use. They could be useful tools especially since recognising dental fear seems difficult for dentists. The COVID-19 pandemic has complicated dental care for the most fearful individuals.

Self-reported factors for improving patient's dental care: A pilot study.

ObjectivesPatient‐centered approach can offer valuable information in improving dental care, but literature is scarce. This study aimed to evaluate self‐reported factors beneficial for attendance in dental care.Material and MethodsSurvey data were collected during the summer of 2020 comprising both structured questionnaires and an open question on factors considered beneficial for dental attendance. Voluntary patients over 15 years of age (n = 196, 98%) agreed to fill the questionnaires, and n = 112 of them (57%) also gave open commentary in an urgent dental care clinic, City of Oulu, Finland, comprising the study population. Dental fear was assessed by Modified Dental Anxiety Scale (MDAS) sum scores (min 5, max 25). All utterances (n = 181) on an open question were evaluated by inductive content analysis to create sub‐ and main categories. Covid‐19 pandemic case counts in Finland were low at the time of the survey, but their effect on seeking dental care was asked. The distribution of patients was evaluated by cross‐tabulation, considering their age, gender, and dental fear status; the significance level was p < .05.ResultsFemales dominated slightly the study population (57%). The mean age of the respondents was 44 years. Half (50%) had moderate (MDAS score 10−18), and 10% had severe dental fear (≥19). The open responses could be categorized into four main categories. The largest main category by patient count concerned factors related to personnel (29%), followed by the patient (28%) and treatment (25%) related, and administrative factors (19%). Males chose factors falling into categories of administration and treatment while females chose patient and personnel‐related factors (p = .048). Compared to the rest, fearful persons (MDAS > 9) reported more often factors related to personnel and treatment (p = .03). Of all participants, 17% reported seeking less dental care during the pandemic.ConclusionsPatients value dental personnel and treatment‐related factors, specifically those with fear.

DETERMINANTS OF DENTAL ANXIETY AMONG PATIENTS VISITING A DENTAL INSTITUTE IN HIMACHAL PRADESH, INDIA: A CROSS-SECTIONAL STUDY

BACKGROUND: Dental anxiety is a known barrier in accessing dental health care and an established factor related to poor oral health. This paper reports on prevalence of dental anxiety and associated factors among patients visiting a dental institute in Himachal Pradesh, India. METHODS: The study was conducted on 200 patients who visited Himachal Institute of Dental Sciences, Paonta Sahib (HP) for dental treatment. Data on dental anxiety were collected using a self-completed questionnaire and were measured by the Modified Dental Anxiety Scale (MDAS). Data were analyzed using SPSS version 16 at significance level of 0.05. RESULTS: The mean MDAS score was 9.3±4.0 and the prevalence of dental anxiety was found to be 37%. Dental anxiety was found to be higher among females (P&lt;0.001), participants of lower age (P&lt;0.001), and those who had never visited the dentist before (P=0.028). Dentally anxious individuals were also found to have less number of filled teeth compared to those without dental anxiety (P=0.020). CONCLUSION: Dental anxiety was found to be significantly associated with age, gender, and dental visiting pattern.

Estimating the Need for Sedation in Patients with Dental Anxiety and Medical Complexities Reporting to Tertiary Care Dental Hospital Using the IOSN Tool.

Objectives To provide consistent method for assessment of sedation need among patients undergoing dental treatment based on specific risk factors that is dental anxiety, medical status, and treatment complexity of needed dental treatment using IOSN (indication of sedation need) tool for assisting the clinician in decision making process. Methods A total of 237 patients aged ≥12, ASA I and II were enrolled in the study. A structured questionnaire comprising of three sections was distributed among the participants. Section 1 comprises details about age, gender, literacy level, occupation, monthly income, and previous dental treatment history. Section 2 is based on Modified Dental Anxiety Scale which is a questionnaire comprising of five questions ranging from “not anxious” to “extremely anxious.” The third section was based on using the IOSN tool comprising three components: MDAS (Modified Dental Anxiety Scale) rank score, Systemic Health (ASA status) rank score, and treatment complexity rank scores. The total of three scores was then computed to determine the total rank score which suggested the sedation need. History of past traumatic dental experiences was also inquired from each patient. Results A total of 237 patients aged ≥12, ASA I and II were enrolled in the study, out of which 56.1% were female. Statistical analysis was conducted by using the IBM SPSS Statistics 23 software. Based on the MDAS score, 47/237 (19.8%) participants were found to be highly anxious related to dental procedures. 34.6% of the participants showed to have a high sedation need while performing a dental procedure. The sedation need was found to be significantly associated with the female gender with a significant p value of (p=0.016), higher education status (p=0.016), and history of previous traumatic dental experience (p < 0.001). Conclusion A simple assessment tool can enable clinicians in their decision making to identify patients in need for dental treatment under sedation based on patient-specific risk factors such as past traumatic dental experiences. Need for sedation can be assessed by information on patient anxiety level towards dental treatment, medical history, and complexity of planned dental treatment. The IOSN tool is a simple and quick assessment tool that can be applied for preprocedural assessment of sedation need for dental treatment.

Fibromyalgia syndrome and dental anxiety

BackgroundFibromyalgia syndrome (FM) is often accompanied by anxiety. Dental anxiety is common in society and negatively affects the application of patients to the dentist.AimsWe aimed to examine the presence of dental anxiety in FM patients and to compare it with the non-FM controls. The aim was also extended to examine the relationship between FM disease severity and dental anxiety.MethodsSixty-three patients diagnosed with FM and 50 age- and sex-matched non-FM controls were included. All participants were asked to answer the Modified dental anxiety scale (MDAS) and the Hospital Anxiety and Depression Scale (HAD anxiety and HAD depression, respectively). FM patients were also asked to answer the Fibromyalgia impact questionnaire (FIQ).ResultsThere were 18 (28.57%) participants in the FM group with an MDAS score of ≥ 16 (anxiety), and 3 (6%) participants in the control group. All 10 participants with MDAS score ≥ 19 (dental phobic) were in the FM group (15.87%). There was a moderate positive correlation between FIQ score and MDAS Score. There were significant positive correlations between the MDAS Score and HAD anxiety and HAD depression scores.ConclusionsThe frequency of dental anxiety may be high in FM patients and disease activity may negatively affect dental anxiety. This is the first study to examine the presence of dental anxiety in fibromyalgia syndrome and its relationship with disease severity. This study draws attention to the presence of dental anxiety, which will negatively affect dental interventions and follow-ups in Fibromyalgia, which is quite common.